Zusammenfassung
Hintergrund
Angehörige von Patienten auf Intensivstationen haben wichtige Unterstützungsbedürfnisse, die bislang häufig unbefriedigt bleiben.
Fragestellung
Beschreibung der Belastungen und Bedürfnisse, Bedürfniserfassung, empirische Evidenz für diese Bedürfnisse, Güte der Bedürfnisbefriedigung; Unterstützungsangebote und Wirksamkeit kommunikativer Empfehlungen für diese besondere Situation.
Material und Methoden
Auswertung von Literaturübersichten, Diskussion von qualitativen und quantitativen Grundlagenarbeiten, Metaanalysen und Expertenempfehlungen.
Ergebnisse
Angehörige von Patienten auf Intensivstationen benennen kognitive, emotionale, soziale und praktische Unterstützungsbedürfnisse. Wichtige Bedürfnisse, wie die Aufrechterhaltung von Hoffnung und Sicherheit sowie eine aufrichtige, bedarfsgerechte Kommunikation, werden bislang unzureichend wahrgenommen und selten angemessen befriedigt. Die Gewichtung und Priorisierung von Bedürfnissen wird durch soziodemographische und kulturelle Faktoren beeinflusst. Psychoedukative Interventionen verbessern das psychische Befinden der Angehörigen. Kommunikative Strategien für die Behandler verringern bei den Angehörigen das Risiko einer posttraumatischen Belastungsstörung, reduzieren Ängstlichkeit und Depressivität und verbessern die partizipative Entscheidungsfindung.
Schlussfolgerungen
Behandler sollen für die Spezifika dieser besonderen Situation sensibilisiert und kommunikativ geschult werden. Für die Behandler ist Selbsterfahrung hinsichtlich der eigenen psychischen Abwehrprozesse ebenso wichtig wie die Verfeinerung der kommunikativen Kompetenz zur Erschließung und angemessenen Berücksichtigung der subjektiven Erlebenswelt der Angehörigen. Auf bestehende Unterstützungsangebote sollte hingewiesen und zur Inanspruchnahme ermutigt werden.
Abstract
Background
Relatives of patients in intensive care units (ICU) have important supportive care needs which are often unrecognized and rarely satisfactorily met.
Objectives
Description of stress factors and strains as well as supportive care needs, assessment of care needs, empirical evidence for care needs, satisfaction of care needs, options and efficacy of psychosocial support and communication recommendations for this special situation.
Material and methods
Evaluation of literature review articles, discussion of basic qualitative and quantitative research findings, meta-analyses and expert recommendations.
Results
Relatives of ICU patients report a number of cognitive, emotional, social and pragmatic support needs. Important needs, such as maintenance of hope and security as well as sincere and needs-adjusted communication often remain unrecognized and are rarely satisfactorily met. The weighting and prioritization of support needs are modulated by sociodemographic and cultural factors. Psychoeducative interventions reduce the psychosocial distress of family members. Communicative strategies of healthcare professionals reduce the risk of posttraumatic stress disorders for family members, reduce anxiety and depression and improve participative decision making.
Conclusion
Healthcare professionals in ICUs should be sensitized to the specific characteristics of these special situations. For healthcare professionals it is equally important to improve self-awareness regarding their own defense mechanisms and to refine communicative competence on accessibility and adequately address the reality of subjective experiences of family members. Psychosocial support services should be recommended and utilization should be encouraged.
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K. Hönig und H. Gündel geben an, dass kein Interessenkonflikt besteht.
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Hönig, K., Gündel, H. Angehörige auf der Intensivstation. Nervenarzt 87, 269–275 (2016). https://doi.org/10.1007/s00115-016-0069-1
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DOI: https://doi.org/10.1007/s00115-016-0069-1